First Step newsletter: Autumn 2021
We want to encourage our community to have open and honest conversations about alcohol and other drugs. We want to reduce stigma because we know this is a barrier to people seeking care. And we want to keep people safe, engaged and empowered to make better choices about their health. We know this saves lives.
May 7th is International Harm Reduction Day. Harm reduction is grounded in the principles of justice and human rights – that people should not be judged or coerced to stop using drugs as a precursor to support.
In the lead up, we are running a social media campaign aimed at reducing stigma associated with addiction, mental health and harm reduction strategies and promote our own harm reduction approach, such as peer education, pharmacotherapies such as methadone, access to overdose prevention and reversal, promotion of needle and syringe programs, psychosocial support, and the provision of information on safer drug use.
To make sure our message is wide-reaching, we have been joined by high profile advocates in harm reduction – Rev Tim Costello, Prof Pat McGorry, Gus Clelland and Paul Wheelton to name just a few.
Make sure you follow us on Facebook, Instagram, Twitter or LinkedIn so you don’t miss their important calls for compassion, reform and support.
The campaign will culminate with a matched Giving Day. Each dollar you donate before May 7th is doubled by generous major donors. The funds raised go directly to support our work in reducing and responding to alcohol and other drug related harms.
Please dig deep and know that your donation will have twice the impact.
Chief Executive Officer
Sometimes, hope is hard to come by in the early stages of recovery. Sometimes it is hard to believe change is possible. And it is in these moments that ResetLife Peer Support workers play their most important role – they hold the hope.
ResetLife is an abstinence-based 16-week program that includes individual, group and family education sessions, and is supported by qualified therapists and peer workers.
Peer Support workers in ResetLife have completed the program and have a deep understanding of the journey the participants are on. People are not always aware of the progress they are making, so we reflect this back to them by pointing out that they might now be sleeping through the night, or that their relationships are more connected.
We provide perspective, encouragement and motivation. And we remind them that success is a slow, incremental process that happens over time. As long as they are engaged, they are rebuilding their self-confidence and they are working towards their own goals, they are succeeding.
It takes a leap of faith for people to invest time, effort and energy into changing their lives and by highlighting the glimpses that things are getting better, they borrow hope from us.
Peer Support Coordinator
First Step Legal is piloting two new Health Justice Partnerships
In our legal work, we recognise that our clients are typically in pain, and that the intensity of any anti-social or criminal behaviour often directly correlates with the severity of their addiction, which also typically correlates with the intensity of the impact of their own, personal trauma.
Criminal charges, family violence matters, dishonesty and driving offences, as well as drug related offences are addressed in a way that does not compromise rehabilitation efforts or exacerbate mental health problems.
First Step Legal aims to achieve court outcomes that are supportive of a client’s ongoing recovery in the community and allow sufficient time for stabilisation and progress in recovery before finalising legal matters.
The close working relationship forged between practitioners including GP’s, mental health nurses, lawyers, psychologists, psychiatrists, care co-ordinators and various other allied health professionals, facilitates nuanced treatment and enables sometimes competing needs be actively integrated.
Significantly, the fact that our lawyers are integrated within a team of professionals who have taken the time to understand the complexity of a client’s experience, means our clients feel safe to disclose information regarding their legal matters, and trust us with the matter so they can focus on their recovery.
First Step Legal is a unique health justice partnership. At their core, health justice partnerships are collaborations that embed legal help in healthcare services. They deliver an integrated, holistic response to the individual’s health and legal needs, with the wider goal of improving client wellbeing. The assumption is that health and legal strategies pursued in partnership will have better outcomes than standard services provided in health and legal silos.
A primary objective of health justice partnerships is to better reach individuals who are disproportionately burdened with legal need, but less likely to seek help directly from lawyers.
Over the past decade First Step Legal has developed considerable expertise in delivering legal services as part of an embedded, collaborative service model involving a wide range of health professionals.
In 2020, new core funding provided through the Community Legal Services Program provided us with capacity to expand services beyond the clients of First Step. We initiated a scoping exercise to determine the nature and volume of unmet legal need in the local community which showed that clients of Star Health’s family violence program and Alfred Health’s St Kilda Road Community Mental Health Clinic were experiencing significant unmet demand for legal assistance.
We are now about to commence two new pilot health justice partnerships with both organisations, which we hope will contribute positively to the clients we serve and the body of developing evidence for this model of practice.
Substance use can happen to anyone
Two things are simultaneously true.
Fact #1: The combination of mental ill-health and substance use (alcohol or other drugs) can happen to just about anyone.
You, me, your parents, your friends. It is really important that as a society we get our heads around this. Just like with physical health, we are seldom in perfect nick and we have our ups and downs. Just like with physical health, sometimes it’s serious enough to require professional intervention.
All of us. Any of us.
Fact #2: Chronic substance use and mental illness are concentrated in areas of disadvantage and poverty.
It’s kind of obvious that absolute poverty is a cause of ill-health – think perhaps of a developing country with insufficient food supply. But relative poverty (being poorer than those around you, suffering the disadvantage and stigma) is also a source of ill-health. Australia is growing ever more unequal, and poverty is the ‘cause of the causes’ of chronic mental ill-health.
We all experience pain and loss as children and adults. However, we need to appreciate that there is a tangible difference in expected life outcomes between those of us who had a relatively stable upbringing (often characterised by having at least one constant, caring parent) and those who did not. This is about acknowledging that there are things we all need, the absence of which creates vulnerability, sows the seeds of neglect and abuse and leaves trauma in its wake.
Connection vs isolation. Support vs neglect. Financial resources vs poverty. Encouragement vs silence. Love vs nothing. Any human being sliding to the right on some of those scales will need to summon extraordinary resilience and ingenuity just to survive.
What do we do with this information? We apply our compassionate minds to the project of understanding. We need to see our own vulnerability as we imagine the child that lacks what we all know are essential elements for the daily experience of happiness. See our own vulnerability and remember our own struggles as we imagine the teenager who never had these things. Picture the young person who made it to 18 years of age without once being told or showed that they were loved, perhaps recently moved to their 20th group home or foster family. The likelihood of early school leaving, pre-teen alcohol and drug use, periods of homelessness and interaction with the law are exponentially more likely for any human being suffering ‘adverse childhood events.’ And the adult? Yes, I think we'd better maintain our compassion for them too.
So, what do we do about this injustice, this inequality, this suffering? We look after ourselves and our own mental health, we look after our friends and family, and we seek to contribute in some way to a society where people get all the help they need. Mental health. Addiction. Cancer. Same same. Integrated, state of the art support to alleviate pain and suffering, and quite possibly save a life. To do less is unacceptable.
And what is the fundamental difference between cancer and addiction or mental illness? Simply stigma.
Do we deny cancer care to my aunty Lorna who smoked her whole adult life? Do we write-off her illness as self-inflicted and her care as doomed to fail? Hell no! We fight the good fight. We allocate resources, we build the Peter McCallum Cancer Centre, we research, we give a damn. We reduce harm as a matter of principle. Let’s get over the stigma and do a bit more of that in the field of addiction.
We are in a period of extraordinary reform in the mental health sector. Don't let addiction be an afterthought.
Recovery is often linked to social inclusion
“I started attending the Men's Group in February 2020, and I have been doing weekly sessions for over a year now. I struggle with mental health, isolation and disconnection, Benn's weekly topics groups help me stay connected to like-minded people struggling with similar experiences. It is a safe space where I can be myself and discuss my challenges, struggles and successes” – Duan
Isolation and loneliness have a significant exacerbating effect on addiction and mental health. And the opposite holds true as well – addiction may be the cause of isolation.
Growing up in out-of-home care, with parents suffering from addiction or in extreme poverty, most First Step clients have histories of childhood trauma including neglect and abuse. These kinds of experiences impair a person’s ability to form trusting and meaningful relationships later in life.
People recovering from addiction typically cite stress as their primary trigger for cravings. Social connection is one of the best buffers against stress - it relieves the stress of isolation, creates more resources available to solve problems, and relieves health problems linked to chronic loneliness such as high blood pressure, poor immune function and heart disease. These health problems are already aggravated by substance and alcohol use.
People rarely recover from addiction in isolation. Recovery is often closely related to social inclusion and meaningful connection with community. For many people, it means finding new networks of people who can support their journey.
With the exceptional generosity of the Marian and E.H. Flack Trust, First Step ran a men’s group throughout 2020 with great success.
“The Marian and EH Flack Trust has supported First Step for a number of years as we can see the multi-disciplinary approach is making a significant difference to many lives. We are impressed by the brave and innovative approach being taken by First Step to address all issues encountered by their clients.
The Trust was very pleased to contribute to the St Kilda’s men’s group in 2019/20. This program was a resounding success and the online delivery required due to COVID resulted in the program being accessible to even more participants.”
– Alison Beswick, Executive Officer, Marian and E.H. Flack Trust
Facilitated by a mental health/AOD therapist, parts of the group were self-directed by participants and their needs, whilst other elements were structured drawing on a range of treatment interventions including cognitive behavioural therapy, motivational interviewing and psychoeducation. There was a range of topics including values/beliefs, defining family, connection, positive personal characteristics, emotional intelligence, communication, identifying needs versus wants, goal setting, family violence, addiction, mental health, legal issues, social outings and parenting – just to name a few.
Initially run face to face from the Christ Church Community Centre, the group quickly adapted to online sessions when COVID-19 forced a lockdown.